Current Status of Anesthesia for Emergency Surgical Patients / 대한마취과학회지

ABSTRACT

Emergency surgical patients are more frequently critical to anesthesia and surgery more than elective cases. They are not ready to anesthesia and surgery, because they have not enough time for physical and laboratory examinations. In addition, they are usually exposed to operative situations to anesthetists and/or surgeons who made little assessments of patient's pathological and physical conditions. The goal of preoperative preparation is to assess the degree and process of disease with physiological changes and to improve them before surgery as possible and to get the better outcome of anesthesia and surgery. The outcome of emergency operation influenced by good or poor physiological states and many factors, that is , preanesthetic assessment, laboratory examination, operation time(day time or night), operative personnel(professor or trainee)and coorperating system in operating theater. We analized 1406(male 704, female 702) emergency surgical patients from March 1990 to February 1991 in order to find out andy problems in procedures of emergency anesthesia and/or surgical patients. The results were as follows. 1) The rate of emergency operation was over-all 19.1 percent. The was no sexual difference in number of patients and third and fourth decade of age group were highest candidates for emergency operation(52.9%). 2)Emergency patients were prevalent in obstetic(28.6%) and general surgery department(25.2%) and acute appendicitis was most common emergency disease in both sex, if excluding Cesarean section. 3)Over-all rate of cesarean section was 33.9%, of which 54.4% were managed in emergency situation. 4)Physical status by ASA classification was mainly in 1E and 2E status(72.7%). 5)Almost of cases(87.7%) were operated under endotracheal inhalational anesthesia and enflurane was mainly administered for them as inhalation anesthetics(84.4%). 6)Anesthesis was started in day-time(47.2%) and in extr-day time(52.8%). With above results, we recognized that these emergency cases resulted in good outcomes because they were in mostly good physical status(1E and 2E), relatively healthy adults, and noncomplicated disease process. However we hope that anestheslologists as well surgeons should always be careful to check and manage emergency operating patients in the perioperative period.